AIIMS Bhopal NO - 2018 (Shift-1st)
Pharmacology
Easy
An Extrapyramidal symptom that is a potentially irreversible side effect of chlorpromazine and other antipsychotic drugs is?
Appeared in: AIIMS Bhopal NO - 2018 (Shift-1st)
Explanation
- Tardive Dyskinesia (TD) is a neurological syndrome characterized by involuntary, repetitive movements of the face, tongue, and limbs.
- It is a well-known, potentially irreversible side effect that occurs after long-term (months to years) use of antipsychotic medications.
- The key differentiator from other extrapyramidal symptoms (EPS) is its late onset and potential for permanence, even after the medication is discontinued.
Why Other Options Were Wrong
- Option A: Torticollis is a form of acute dystonia, characterized by spasms of the neck muscles. It is an acute, painful, but typically reversible side effect that occurs early in treatment.
- Option C: Oculogyric crisis, an involuntary upward deviation of the eyes, is another type of acute dystonic reaction. Like torticollis, it is frightening but reversible with prompt treatment.
- Option D: Pseudo-parkinsonism involves symptoms like tremor, rigidity, and bradykinesia that mimic Parkinson's disease. It is a common EPS but is generally reversible by lowering the dose or stopping the drug.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Irreversible Extrapyramidal Symptoms of Antipsychotic Drugs helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- The nurse's primary role is vigilant monitoring for EPS in any patient receiving antipsychotics. The Abnormal Involuntary Movement Scale (AIMS) is a critical tool for early detection of Tardive Dyskinesia.
- Early detection and reporting of TD symptoms to the provider is crucial, as it offers the best chance to prevent irreversible changes by adjusting the treatment plan.
- What if? If a patient on haloperidol (a high-potency first-generation antipsychotic) develops TD, the provider is more likely to switch them to a second-generation antipsychotic (e.g., clozapine, olanzapine) which has a lower risk of causing TD.
How to Approach the Question
- First, identify the key terms in the question: 'Extrapyramidal symptom' (EPS), 'potentially irreversible', and 'antipsychotic drugs'.
- The most crucial term here is 'potentially irreversible'. This directs you to differentiate between the long-term and short-term side effects of these medications.
- Recall or look up the different types of EPS. These include acute dystonias (like torticollis, oculogyric crisis), akathisia, pseudo-parkinsonism, and tardive dyskinesia.
- Categorize each option based on its typical onset and reversibility. Torticollis, oculogyric crisis, and pseudo-parkinsonism are known to be acute or subacute and are generally reversible.
- Identify Tardive Dyskinesia as the chronic, late-onset syndrome that is known for being potentially permanent.
- This process of elimination based on the 'irreversible' criterion leads to the correct answer.
Concept Tested & Keywords
- Concept Tested: Irreversible Extrapyramidal Symptoms of Antipsychotic Drugs
- Stem keywords: Extrapyramidal symptom, irreversible side effect, chlorpromazine, antipsychotic drugs
- Lead-in keywords: is
- Negative lead-in flag: false
Question ID
Qslk65Zl78_ockOJ6cTQkr
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 10037-10039, 9898-9900, 10791-10793
Practise the full AIIMS Bhopal NO - 2018 (Shift-1st)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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